A question and answer fact sheet on the use of ski helmets by Safe Kids Canada has been released at an appropriate time for the Australian winter ski season. It is the result of an international review which concluded that head injuries are the most common cause of death among skiers and snowboarders and recommends the mandatory use of suitable helmets when participating in snow sport activities.
Paul Shrubb, RR+R’s Managing Director commented “Risk Response + Rescue have a highly experienced alpine team. All our team members wear (their) helmets for any downhill snowsport activity or when operating over-snow vehicles such as skidoo and ATV’s”. Asked his personal opinion he commented “As a rule of thumb, in any land or alpine activity – if your body is going to travel faster than you can run - you should either be retrained, wear a helmet or both. I encourage my family and my staff to wear them”.
Whilst the answers to the questions relate to Canada, the answers are also relevant to Australian skiing conditions.
Are skiers and snowboarders at risk of head injury?
An international review which included Canada concluded that head injuries are the most common cause of death among skiers and snowboarders. Traumatic brain injuries account for 50-88 per cent of the fatalities at ski resorts1 and 67 per cent of skier deaths in children.2 Head injuries comprise 3 -15 per cent of all injuries suffered by skiers and snowboarders.
Novice skiers and snowboarders are most susceptible to injury; however novice snowboarders in particular are more likely to suffer severe head injuries.3 Children and adolescents experience more head and neck injuries than adults, which may be due to a number of factors unique to children. Children have immature muscles and bones that could result in more falls and they tire more quickly from physical activity. In addition they often wear ill-fitting ski equipment due to their continued growth from one ski season to the next.4
What kind of head injuries can occur?
Overall head and spinal cord injuries are increasing.5 The majority of head injuries (83 per cent) are concussions.6 Concussions represent 9.6 per cent of injuries in skiers, 14.7 per cent of injuries in snowboarders and 5.7 per cent of injuries in snowbladers. For both skiers and snowboarders, traumatic brain injury is the leading cause of death. It is estimated that between 50 and 88 per cent of deaths can be related to traumatic brain injury.7
Does wearing a helmet effectively protect a skier or snowboarder?
Several studies have demonstrated that ski and snow board helmets are effective at preventing head injuries.8 It is estimated that for every 10 people who wear a helmet, up to five may avoid head injuries.9 Studies also show that even at a speed of 19km/h, a ski helmet can minimize brain damage.10 Helmets may prove to offer even greater protection, as many individuals wear them incorrectly.11 Current evidence is limited on the relationship between helmet use and neck injury.12
Do helmets make skiers take more risks?
A 2007 study demonstrated that skiers and snowboarders who wore helmets actually traveled at slower speeds and challenged themselves less than non-helmet wearers.13 Similar studies concerning cyclists and hockey players indicate that using a helmet or safety equipment does not lead to increased risk- taking.14 15
How many people in Canada have serious injuries from skiing and snowboarding?
Nearly 1,800 people were hospitalized with serious injuries from skiing and snowboarding in 2005.16
How many children in Canada are injured from skiing and snowboarding?
In 2005, 1,629 children under the age of 15 visited emergency departments and 375 children were hospitalized for serious injuries from skiing and snowboarding.17
Is helmet fit important?
In order for helmets to protect adults and children properly, they must be correctly fitted and secured. Ski and snowboard helmets should rest two fingers width above the eyebrow and the helmet should be snug and comfortable, with only one finger width under the chinstrap. The helmet pads should touch the cheeks and the forehead, and the helmet back should not touch the nape of the neck. If wearing goggles, there should be little or no gap between the top of the goggles and the helmet. Most helmets come with fitting instructions.
When should a ski or snowboard helmet be replaced?
If a helmet has been dropped or the wearer has been in a fall or collision while wearing the helmet, a new one should be purchased, even if it appears undamaged.
Is it safe to use a second-hand helmet?
Using a second-hand helmet is not recommended. The accident history and the age of the helmet cannot be assured if the helmet had been previously used. A helmet that has been in a crash, or is over five years of age, should be replaced. Helmet plastics do not retain their integrity over time, and lose the ability to protect properly, even if they appear intact. In addition, older helmets may not meet current safety standards, or they may have missing or broken parts.
What current helmets standards are available in Canada?
Helmets for sale in Canada should have certification from CE, Snell or ASTM. These are designed as single-impact helmets. In 2008 the Canadian Standards Association (CSA) released a new standard for a multi-impact ski and snowboard helmet. However, there are no helmets available with the CSA seal because no helmet currently meets the CSA standard.
Which helmets are recommended for tobogganing?
Experts recommend a ski/snowboarding helmet for tobogganing. Since the activity of going downhill is a similar mechanism of injury for tobogganing, a ski/snowboarding helmet is an appropriate choice. Certification from CSA, CE, Snell or ASTM is important when selecting a helmet.
Would mandatory helmet use for alpine sports discourage participation in these activities?
Individuals who are motivated to participate in a particular activity do not appear to be deterred because of safety equipment requirements. Canadian research regarding mandatory bike helmet legislation demonstrates that children have not reduced their cycling activities as a result of helmet laws.18 Recreational hockey also requires helmet use, and continues to be a popular Canadian winter sport.
Why does Safe Kids Canada support legislation for mandatory helmet use?
Head injury is the leading cause of death for skiers and snowboarders, and it has been clearly demonstrated that legislation requiring cyclists to wear helmets has been effective in reducing head injuries. Safe Kids Canada is working with relevant stakeholders in the ski and snowboard industry to find an effective, feasible approach that can reduce injury within the sport.
Would it be difficult to enforce mandatory helmet wear on alpine hills?
Developing mandatory helmet legislation, involves a collaborative approach between ski hill operators and the government. A number of strategies could be developed. For example, chair lift use on alpine hills could become contingent on helmet use. Ski hill operators across Canada could implement a "no helmet; no lift ticket" policy. This could encourage wearing helmets on the hill to become standard practice.
Endnotes
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1 3 5 6 7 8 10 12 Ackery A, Hagel BE, Provvidenza C, Tator CH. An international review of head and spinal cord injuries in alpine skiing and snowboarding. Injury Prevention. 2007;13:368-375.
2 Smith GA, Stallones L, Xiang H. Downhill skiing injury fatalities among children. Injury Prevention. 2004;10:99-102.
4 Higggins W, Laurent C, Meyers M, Shelly W. Downhill ski injuries in children and adolescents. Sports Medicine. 2001;37(6):486-499.
9 Russell K, Christie J, Hagel BE. The effect of helmets on the risk of head and neck injuries among skiers and snowboarders: a meta-analysis. Canadian Medical Association Journal 2010.
11 Goulet C, Hagel BE, Platt W, Pless IB, Robitalle Y. Effectiveness of helmets in skiers and snowboarders: case control and case crossover study. British Medical Journal. 2005.
13 Andersen PA, Butler DB, Cutter GR, Dignan MB, Scott MD, Voeks JH, et al. Testing the risk compensation hypothesis for safety helmets in alpine skiing and snowboarding. Injury Prevention. 2007;13:173-177.
14 Bueno-Cavanillas A, de Dios Luna-del-Castillo J, Gálvez-Vargas R, García-Martín MA, Lardelli-Claret P, Jiménez-Moleón JJ. Risk compensation theory and voluntary helmet use by cyclists in Spain. Injury Prevention. 2003;9:128-132.
15 Benson BW, Mohtadi NG, Meeuwisse WH, Nicholas G, Rose MS. Head and neck injuries among ice hockey players wearing full face shields vs half face shields. JAMA. 1999;282(24):2328-2332.
16 17 Public Health Agency of Canada. 2005 unpublished data.
18 Macpherson AK, Parkin PC, To TM. Mandatory helmet legislation and children's exposure to cycling. Injury Prevention. 2001;7:228-230.
